Excessive sweating or hyperhidrosis affects about 1% of the population. This generally begins around puberty. Although not a disease in itself, it does cause acute social embarrassment for many people who are affected with excessive sweating.
Excessive sweating causes social embarrassment due to the sweat marks which are evident on their clothes. Often people find they can only wear certain coloured clothing because of the ‘tide marks’ of sweat. Also for some, a malodour associated with perspiration is problematic. Others report an acute problem when they are publicly speaking or when they are under stress.
It is always prudent to undergo a thyroid function blood test to ensure that the thyroid hormone is not overactive as this can cause excessive sweating. Many people try numerous types of anti-perspirants without success. Also some consider undergoing an operation called a ‘Lateral Sympathectomy’ which is a surgical laparoscopic procedure that severs some of the nerves running along the spine which control the sweating reflex. Many people find this option rather intimidating and prefer to use botulinum therapy (Botox or Dysport) to minimize their sweating.
Excessive sweating can occur under the arms, on the hands, on the forehead and on the feet. The simplest area to treat with botulinum therapy is the under-arms. The Allergan (the company that produces Botox) recommended standard dose for this area is 100 units. Less can be used and some elect to have a half dose, however it is not as strong and the anti-perspirant affect does not last quite as long. The average duration of treatment is approximately seven months. It takes three to five days for the Botulinum therapy to begin to work, and two weeks before it has fully kicked in. Generally people notice hardly any sweating whatsoever for the first couple of months after treatment however thereafter some mild perspiration is noted. This is generally less than what an average person would experience with respect to sweating under the arms.
Usually people elect to have numbing cream applied to their under-arms prior to their Botulinum therapy injections. This is generally applied approximately half an hour prior to the procedure. Often a ‘starch iodine’ test is used prior to the injections to assess where the sweat glands are concentrated.
Side effects from the treatment of hyperhidrosis under the arms are usually mild. There are some raised mosquito bite marks for approximately an hour after treatment. Also mild bruising is often encountered at the injection site. A very rare side effect is muscular weakness however the muscles are very deep in relation to the under-arm area and this is highly unusual. Allergies to Botulinum therapy are rare. There are also rare occurrences of antibodies or immunity developing to Botulinum therapy but this unusual phenomenon and usually only occurs when doses of more than 100 units are used.
There is no aftercare required for treatment of excessive sweating under the arms. It is recommended antiperspirant is avoided for 24 hours prior to treatment and for 24 hours after.
Botulinum therapy is a simple and effective treatment for excessive sweating or hyperhidrosis and can improve affected people’s quality of life.
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